2

ÄST

HET

ISC

HE

MED

IZIN

ÄST

HET

ISC

HE

DER

MA

TOLO

GIE

1 | 2

014

Aesthetic Dermatology:Dr. Tretti Clementoni, you are one of the first users world-wide of the M22 ResurFX, a non-ablative, fractional 1565nm fiber laser. Tell us about your experiences with the de-vice so far.

Dr. Tretti Clementoni:When I received the laser in May 2013, it really surprised

me, because the results I had on stretch marks were really

good from the beginning. A lot of patients are now asking

for this kind of procedure and they are very happy about

the results. This technology is now my first choice to treat

stretch marks and it allows me also to offer a new proce-

dure for facial skin rejuvenation. IPL devices work very

well on pigmented and vascular lesions but there is only a

medium new collagen formation. With the fractional CO2

you can obtain fantastic results but it requires 5-6 days of

downtime. ResurFX stays in the middle. It allows obtaining

better results than an IPL treatment with a shorter

downtime than you can observe with a fractional CO2.

Aesthetic Dermatology:What are the main differences between ResurFX and forinstance Fraxel system?

Dr. Matteo Tretti Clementoni, born in 1968, graduated in 1993 with first-class honors at the University of Bologna andfinished afterwards his course in specialization in Plastic and Reconstructive Surgery, beside working and expandingin the laser field. After working as a Medical Officer for the Italian National Military Police, he continued his medicalcareer as Plastic Surgeon, first at the Multimedica General Hospital and afterwards at Casa di Cura Santa Rita in Milan.Having started an own professional practice simultaneously with his hospital career, he concentrated his activities ex-clusively on it from 2007 onwards. We talked to Dr. Tretti Clementoni about his experiences using a new fractional,non-ablative 1565 nm fiber laser.

Fractional, non-ablative skinresurfacing using a 1565 nm fiber laserInterview with M. Tretti Clementoni, Milan (Italy)

Dr. Tretti Clementoni:I currently do not have a Fraxel device, but I tried to use it

and applied it as well. Advantages are: ResurFX has non-

disposable tips – which is important from the economical

point of view. ResurFX allows me to be extremely precise

during my treatments, and the most important thing is

that you can vary not only the energy, but also the shape

of the shot and the number of micro-beams. Therefore

with a single pass I can decide whether to be more or less

aggressive and avoiding the time consuming multiple pass

technique. Also the lasting is very important. Its advantage

is that micro-beams are emitted in a random modality. Ha-

ving not a stamping emission as well as having not a se-

quential emission, I can use high energy avoiding any risk

to deliver too much heat going simultaneously very deep

in the skin. The Fraxel was invented in 2006/2007, but

with a newer laser device you have some more advantages.

Aesthetic Dermatology:When do you apply the ResurFX, and when would you rather use a CO2 laser?

Dr. Tretti Clementoni:There are different parameters to be acknowledged. Regar-

ding the downtime, CO2 lasers always have a longer

downtime. In terms of the results, you have better results

with CO2 lasers and you may in some cases only need one

session of treatment.

With a CO2 laser you are normally having 5 days of

downtime with crusts, where people cannot go outside and

lead their regular social life; there will be very good results.

Meanwhile the ResurFX downtime is shorter, but you will

need more than one session of treatments.

But we should not compare non-ablative with ablative la-

sers because they have different indications. So I would

never use a CO2 laser on stretch marks again – I will always

use the ResurFX, the non-ablative option. Maybe the non-

ablative laser will have a future also on acne scars, but also

the CO2 laser is very effective on them. I think that the

ResurFX can be used on treatment of scars as well as CO2,

but for different kind of scars. Speaking of rejuvenation, we

are facing two different types of patients: on the one hand

we have patients who are willing to accept moderate re-

sults with a non-ablative laser after the first treatment. And

then there are patients who rather prefer more obvious re-

sults after a longer downtime, who would then be treated

with the CO2.

Aesthetic Dermatology:Which laser do you currently use for scars on the body?

Dr. Tretti Clementoni:It is depending on the scars. I’m always a little worried to

use a CO2 laser on the body in terms of hyperpigmenta-

tion. So if I have a thick scar like a hypertrophic, burn scar,

a post-traumatic one – a second intention healing scar, my

mind goes rather towards the CO2 laser. If we have a recent

red scar, why not start with the non-ablative laser?

Aesthetic Dermatology:You often combine the application of the ResurFX with IPL. Which indications can be treated successfully with this combination?

Dr. Tretti Clementoni:I think that the future will be dominated by combined the-

rapy, combining different technologies to obtain very good

results, reducing simultaneously the risk of adverse effects.

Like treating with antibiotics, we are combining different

drugs to have very good effects and less adverse effects.

The ResurFX is in my opinion not able to treat vascular le-

sions. So if you look at an aging face, you can have three

features: lentigos/pigmented abnormalities or irregularities,

there can be very small vessels and wrinkles. ResurFX can

treat pigments and fine lines, while the IPL is fantastic for

treating the vascular conditions. By combining the two

treatments we can treat all three features of an aging face.

And we are not increasing the downtime, which is an im-

portant issue. The only thing that has to be considered is

ÄST

HET

ISC

HE

MED

IZIN

ÄST

HET

ISC

HE

DER

MA

TOLO

GIE

1 | 2

014

33

4

ÄST

HET

ISC

HE

MED

IZIN

ÄST

HET

ISC

HE

DER

MA

TOLO

GIE

1 | 2

014

that when you use the ResurFX, you will have oedema for a

few minutes – oedema of the skin means that there will be

much more water inside the skin. So using the IPL imme-

diately after the ResurFX is not recommendable. I prefer to

do the ResurFX and then wait some days and then do the

IPL. But I also try to combine both treatments during one

session by using the IPL first, because it does not produce

any swelling and then afterwards use the ResurFX.

Aesthetic Dermatology:What are the main benefits of ResurFX for doctors and for patients?

Dr. Tretti Clementoni:The advantages for doctors are very good results with a

non-aggressive procedure. Advantage for patients would be

definitely the better appearance of the face with a shorter

downtime. ResurFX is also a very good opportunity for

women offering very good results on stretch marks.

Aesthetic Dermatology:How long is the downtime, and in particular how longdoes is take for the irritation to fade?

Dr. Tretti Clementoni:It usually depends on the energy settings you apply. Nor-

mally less than two days, but patients mostly have only

micro-crusts, which can be covered with make-up and so it

is not affecting the social life. The CO2 laser gives you fan-

tastic results but you have to accept a longer period of

downtime.

Aesthetic Dermatology:Please explain how and why you use ResurFX on stretchmarks. How effective is it?

Dr. Tretti Clementoni:At the beginning I was not happy with the results I had

with other devices and they just didn’t convince me at all

and neither my patients. But the ResurFX is another story. I

started to notice some preliminary very good results on

stretch marks and already treated patients were asking me

to treat them again. I consider stretch marks as scars and

the idea is trying to modify the tissue and not only the

color. We must have new collagen as well as a remodeling

of it.

Trying to focus onto the majority of cases I have in my of-

fice every day, I started to treat white stretch marks. On

them we obtained very good outcomes, but I did a few

cases also on red stretch marks. I have no complete

judgment on this kind of indication yet, so I cannot re-

commend it, but my preliminary results are really promi-

sing also on these lesions.

Aesthetic Dermatology:Dear Dr. Tretti Clementoni, thank you very much for taking the time to talk to us! �

The Interview was conducted by M. Lengenberg.